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Background: Interactions between the skin barrier, immune system, and microbiome underlie the development of atopic dermatitis (AD). Objective: To investigate the skin and nasal microbiome in relation to filaggrin gene (FLG) mutations. Methods: A cross-sectional study including 77 children with difficult-to-treat AD. The entire encoding region of FLG was screened for mutations using single molecule molecular inversion probes and next-generation sequencing. Bacterial swabs from the anterior nares, lesional and nonlesional skin were analyzed using 16S rRNA sequencing. For skin samples, additional qPCR was performed for Staphylococcus aureus and Staphylococcus epidermidis. Results: The prevalence of patients with a mutation in FLG was 40%, including 10 different mutations. Analyzing bacterial swabs from all three niches showed a significant effect for both niche and FLG mutation status on the overall microbiome composition. Using a subset analysis to test the effect of FLG mutation status per niche separately did not show a significant association to the microbiome. Shannon diversity and S. aureus abundance were significantly affected by the niche, but not by the presence of an FLG mutation. Conclusions: Our results suggest only a minor role for FLG mutation status on the overall microbiome, which is rather caused by differences in the present genera than by microbe richness and evenness.

Background: Increased hand hygiene measures during the COVID-19 pandemic have led to an increased quantum of hand eczema (HE). Objectives: To examine the effects of varying washing frequencies using current mild cleansing agents—alongside with the effect of a rehydrating cream—on the epidermal barrier function and inflammatory processes of the stratum corneum(SC). Methods: Standardized skin washings on the volar aspects of the lower arms of skinhealthy volunteers were performed using the automated cleansing device either 5 or 11 times within 4 h for 60 s each with a standard cleanser, a lipid-containing syndet, or a lipid-containing syndet followed by one-time application of a rehydrating cream. Skin bioengineering parameters (transepidermal water loss, SC hydration, erythema, and SC pH) and biochemical/immunological parameters (interleukin-1α, interleukin- 1α receptor antagonist and natural moisturizing factor) of SCsamples collected by tape stripping were assessed. Results: All applied washing procedures provided comparable, mild effects on the epidermal barrier function and skin inflammation. Conclusion: Occupational skin cleansers seem to have improved regarding skin barrier damaging effects. To further corroborate this, a study design, modified on the basis of our findings, applying longer washing periods for consecutive days seems desirable.

Introduction A burn is a trauma that breaks the skin barrier, causing local and systemic responses. Treatment is complex, multiprofessional and expensive. In addition to surgical treatment, topical dressings can be used to keep the wound moist, reduce the risk of infection and stimulate healing. Clinical studies show that topical use of fibroblast growth factors may accelerate healing. An assessment of the quality of the available evidence and its strength of recommendation is necessary. Objective This study aimed to evaluate the effectiveness and safety of topical use of fibroblast growth factor, compared to other topical treatments or placebo, in the healing of burns, to determine the strength of recommendation. Method Based on a defined search strategy, randomized and quasi-randomized clinical trials, available in electronic databases, were gathered. These compare the topical use of FGF versus other topical or non-treatment. The primary outcome was healing and as adverse effects: pain, infection and mortality. The systematic review protocol was registered on the PROSPERO platform (CRD42018089556), developed in accordance with the “Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) 2015” and within the “SWiM guideline 2019”. GRADEpro was used for the critical analysis of the methodology of the studies. Results Four clinical trials were found, in which FGF reduced the healing time and improved the appearance of the scar. Two trials were determined to be of low strength, while two others have a moderate recommendation strength. Conclusion This review gathered available evidence, between low and moderate recommendation strength for the use of FGF as a topical dressing. Further rigorous trials are needed to improve the strength of recommendation for topical use of FGF for burns.

Atopic dermatitis (AD) is the most common chronic skin inflammatory disease, with a profound impact on patients' quality of life. AD varies considerably in clinical course, age of onset and degree to which it is accompanied by allergic and non-allergic comorbidities. Skin barrier impairment in both lesional and nonlesional skin is now recognized as a critical and often early feature of AD. This may be explained by a number of abnormalities identified within both the stratum corneum and stratum granulosum layers of the epidermis. The goal of this review is to provide an overview of key barrier defects in AD, starting with a historical perspective. We will also highlight some of the commonly used methods to characterize and quantify skin barrier function. There is ample opportunity for further investigative work which we call out throughout this review. These include: quantifying the relative impact of individual epidermal abnormalities and putting this in a more holistic view with physiological measures of barrier function, as well as determining whether these barrier-specific endotypes predict clinical phenotypes (e.g. age of onset, natural history, comorbidities, response to therapies, etc). Mechanistic studies with new (and in development) AD therapies that specifically target immune pathways, Staphylococcus aureus abundance and/or skin barrier will help us understand the dynamic crosstalk between these compartments and their relative importance in AD.

Allergic contact dermatitis (ACD) is the most prevalent occupational disease and the most common form of immunotoxicity in humans. Preventing exposure to the triggering allergens is the mainstay of treatment. However, avoidance is not always possible in an occupational setting. From a pathophysiological point of view, a variety of events are involved in the development of ACD, including the formation of immunogenic complexes following the stable association of the allergen with skin proteins, which is thought to be the molecular initiating event responsible for the development of ACD. Previously, the team identified molecules that exhibited higher antiallergic potential due to their capacity to block the interaction between allergens and skin proteins. These assumptions were the starting point for the design of this work aiming to develop and characterize a new hydrogel containing the active ingredients lysine and N-acetyl cysteine under the premises of quality- and safety- by design. Two factorial plannings were established envisioning the optimization of the hydrogel in terms of mechanical and rheological properties. In vitro release and permeation studies supported its skin surface barrier effect. In addition, the selected hydrogel proved to be safe without causing human skin irritation or skin sensitization. published

Diet has long been understood to have an intricate association with atopic dermatitis, although much remains unelucidated. Skin barrier dysfunction with dysbiosis and consequent impairment of immune tolerance likely underly the pathogenesis of coincident atopic dermatitis and food allergy. There is a wide range of possible skin reactions to food, complicating the diagnosis and understanding of food allergies. Many patients, parents, and providers incorrectly suspect diet as causative of atopic dermatitis symptoms and many have tried elimination diets. This frequently leads to inaccurate labeling of food allergies, contributing to a dangerous spiral of inappropriate testing, referrals, and dietary changes, while neglecting established atopic dermatitis treatment essentials. Alternatively, certain dietary supplements or the introduction of certain foods may be beneficial for atopic dermatitis management or prevention. Greater consensus on the role of diet among providers of patients with atopic dermatitis is strongly encouraged to improve the management of atopic dermatitis.

Purpose High prevalence, unreliable risk discrimination and poor clinical outcomes are observed in malignant and benign breast diseases (BD). The involvement of microbial communities in the development of BD has become topical, and distal influences of microbial dysregulation in the breast have been well established. Despite advances, the role of the breast skin microbiota in BD remains unclear. Interactions between the skin microbiota and the underlying mucosal immune system are complex. In homeostasis, the skin offers a physical barrier protecting underlying breast tissue from skin commensals and noxious environmental triggers. Our review aims to illuminate the role of the skin microbiota in the development of BD. Methods Adhering to the PRISMA protocol, a systematic review was conducted utilising the Medline and Embase search engines. Results Through a comprehensive search of the last ten years, twenty-two studies satisfied the inclusion criteria. Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes were identified as the most prevalent phyla of both breast tissue and skin in healthy controls and BD. High abundance of skin commensals, specifically some species of Staphylococcus, have been linked in breast cancer and metastases. Similarly, dysregulated microbial abundance is also seen in inflammatory and implant-associated BD. These findings raise the hypothesis that the skin microbiota plays a role in tissue homeostasis and may contribute to a range of breast pathologies. Several mechanisms of microbial transfer to underlying tissue have been proposed, including retrograde transfer through ductal systems, breakdown of the skin barrier, and migration through nipple-aspirate fluid. Conclusion Our review provides preliminary insights into the skin microbiota as a modifiable risk factor for BD. This raises opportunities for future studies in antimicrobials/probiotics as an adjunct to, or replacement of surgery; a diagnostic and/or prognostic tool for BD; and the possibility of conditioning the microbiota to manage BD., Highlights • The breast skin microbiota as a modifiable risk factor in breast disease. • The utilisation of antimicrobial or probiotic treatments in breast disease. • The role of the breast skin microbiota as a diagnostic or prognostic tool in breast disease.

The dysregulation of skin microflora in patients with atopic dermatitis (AD) has become a research hotspot in recent years. Metagenomic studies have shown that microbial diversity is decreased, whereas the Staphylococcus aureus infection is increased in AD. Keratinocytes are the primary barrier against the invasion of external pathogenic microorganisms. Staphylococcus aureus infection can abnormally activate innate and adaptive immune responses in keratinocytes, resulting in a vicious cycle between Staphylococcus aureus infection and AD. This article reviews the mechanisms of inflammatory damage of keratinocytes induced by Staphylococcus aureus infection in patients with AD, providing a theoretical basis for the study of new targeted drugs. This review also suggests for the management of Staphylococcus aureus infection in patients with AD.

BACKGROUND The Picosecond Nd:YAG laser has advantages in skin rejuvenation, which has little damage to surrounding tissues due to the ultra-short pulse width. We perform clinical application of Picosecond Nd:YAG laser's tender skin mode, which could improve the seborrheic dermatitis. MATERIALS AND METHODS Sixty-three subjects with facial seborrheic dermatitis are randomized to be control and observation groups. Records regarding skin subjective improvement, skin barrier function-related data, skin microbial status, and dermoscopy detection of the two patient groups before and after treatments are investigated. RESULTS Improvements of erythema and scales in observation group are significant compared with controls (p

Atopic dermatitis (AD) is a chronic, inflammatory skin condition with a multifactorial pathophysiology. The filaggrin gene (FLG) has particularly been implicated given loss of function (LoF) mutations in this gene lead to skin barrier dysfunction and such mutations can increase a patient's likelihood of developing AD. FLG has intragenic copy number variation (CNV) which impacts the total amount of filaggrin produced. Previous research reported a dose-dependent effect such that as amount of FLG increases, risk of AD decreases. To gain a better understanding, we evaluated FLG CNV in a large case-control study of Whites and Blacks with and without AD. The goal of our study was to determine if FLG CNV has a dose-dependence effect on the risk of developing AD as well as to determine if FLG CNV varies by race. The frequencies as well as odd ratios comparing a given CNV by race or race within those with AD did not significantly vary. It had been thought that FLG CNV might vary by race and represent an important association with AD in Black AD subjects. However, our work suggests that while there are racial differences with respect to CNV, these differences do not appear to explain AD risk.

There is a growing concern amongst patients about topical corticosteroid (TCS) side effects, with increasing discussion of topical steroid addiction (TSA) and topical steroid withdrawal (TSW) particularly on social media platforms. However, the acceptance of TSA/TSW as a distinct condition remains controversial within the dermatological community. We conducted a literature search using PubMed, MEDLINE, Cochrane Library, Google Scholar, Embase and Web of Science to identify original articles addressing TSA/TSW. We described the definition and reported clinical features of TSA/TSW including its classification into erythemato-edematous and papulopustular subtype. To assess the validity of TSA/TSW, we summarised and objectively appraised the postulated mechanisms for this condition, including tachyphylaxis, dysregulation of glucocorticoid receptors, rebound vasodilation and impaired skin barrier leading to a cytokine cascade. Understanding the evidence including its limitations and uncertainties highlights areas for future research and helps medical practitioners better counsel and provide care to patients who may be experiencing or who have concerns about TSA/TSW.

Background This study seeks to establish the skin barrier dysfunction model at the heel via tape-stripping (TS) by evaluating the skin moisturizing effects. Materials and methods Nineteen young, female participated in the study. A sequence of TS was performed at the heel and trans-epidermal water loss (TEWL), stratum corneum (SC) hydration, and surface pH were measured. Following TS, the subjects were divided into three groups: moisturizer, emollient, and overcoat. These agents were applied daily at night, and the skin parameters were measured the next morning for a week. Results The TEWL value of TS immediately and 5 min after TS were significantly higher than what was obtained before TS, while the SC hydration after TS was significantly lower than what was obtained before TS. However, there were no significant differences in the skin parameters among the three agents on day 7 after application, with the two-way ANOVA showing no interaction among the agents and number of days. Conclusion The skin barrier dysfunction model at the heel was established by TS in healthy, young adults. However, the physiological function of the skin at the heel did not change drastically and showed no differences even after continuous application for 7 days.

The protective effects for cells against chemical and UVA stress of a commercial phycocyanin (PC) for food use and a PC extracted from Arthrospira platensis (Spirulina) in phosphate buffer were assessed. The purity of the commercial PC, spectrophotometrically estimated as A620/A280 and confirmed by HPLC, was higher than that of the fractionated PC (2.0 vs. 1.5) but was twofold less concentrated. The oxygen radical antioxidant capacities (ORACs) of the commercial and fractionated PCs were 12,141 ± 1928 and 32,680 ± 3295 TE/100 g, respectively. The degradation of PCs upon exposure to UVA was spectrophotometrically estimated, and cytotoxicity was evaluated with the MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) test on human fibroblasts and keratinocytes. A lower level of reactive oxygen species (ROS) was recorded in the two cell lines incubated with the commercial PC after menadione treatment (p < 0.01) and UVA exposure (p < 0.001) on fibroblasts after 5 min and keratinocytes up to 25 min, compared with controls. Differently, the fractionated PC was not protective and showed significant (p < 0.01) paradoxical prooxidant effects. Overall, the PC for food consumption demonstrated a high safety threshold and antioxidant ability to cells that, along with its coloring power, make it an excellent candidate for cosmetic formulations.

Background Increased frequency of using alcohol‐based hand sanitizers (ABHS) by consumers during COVID times have resulted in increased incidences of skin issues on palms. Objective (1) To quantify skin damage with increased usage frequency of ABHS by consumers and (2) To evaluate Virgin Coconut Oil (VCO) as natural prophylactic agent to counter the adverse effects. Methods In‐home usage study was carried out with 60 volunteers for a 15‐day intervention—Control Group: 6 applications per day of ABHS and Test Group: Overnight VCO use (6–8 drops) followed by 6× usage per day of ABHS. This leg included dermatological evaluation and WHO Self‐Assessment Scale for skin health. Another leg of measurement included non‐invasive instrumental study (Moisture & TEWL Probes, Tape Strip for protein content and IR spectroscopy for protein & lipid content) on forearm of 12 subjects (25–60 years age) with and without VCO application and repeated alcohol exposure. Results In‐home usage study established consumer experiencing skin protective effect of VCO in the context of ABHS onslaught. 25% increase in perceived moisture content was recorded for VCO users, using WHO Self‐Assessment Scale. Instrumental studies confirmed an increase in TEWL and decrease in lipids & protein content. Overnight VCO application resists the extraction which builds up with repeated application. Conclusions Current work provides evidence of compromised hand skin barrier with ABHS daily usage. Overnight VCO application helps prepare the skin for next day alcohol use. Based on the findings, a regimen of overnight VCO application on hands as a natural prophylactic is recommended.

Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterized by eczematous and pruritic skin lesions. In recent decades, the prevalence of AD has increased worldwide, most notably in developing countries. The enormous progress in our understanding of the complex composition and functions of the epidermal barrier allows for a deeper appreciation of the active role that the skin barrier plays in the initiation and maintenance of skin inflammation. The epidermis forms a physical, chemical, immunological, neuro-sensory, and microbial barrier between the internal and external environment. Not only lesional, but also non-lesional areas of AD skin display many morphological, biochemical and functional differences compared with healthy skin. Supporting this notion, genetic defects affecting structural proteins of the skin barrier, including filaggrin, contribute to an increased risk of AD. There is evidence to suggest that natural environmental allergens and man-made pollutants are associated with an increased likelihood of developing AD. A compromised epidermal barrier predisposes the skin to increased permeability of these compounds. Numerous topical and systemic therapies for AD are currently available or in development; while anti-inflammatory therapy is central to the treatment of AD, some existing and novel therapies also appear to exert beneficial effects on skin barrier function. Further research on the skin barrier, particularly addressing epidermal differentiation and inflammation, lipid metabolism, and the role of bacterial communities for skin barrier function, will likely expand our understanding of the complex etiology of AD and lead to identification of novel targets and the development of new therapies.

Erythroderma (exfoliative dermatitis), first described by Von Hebra in 1868, manifests as a cutaneous inflammatory state, with associated skin barrier and metabolic dysfunctions. The annual incidence of erythroderma is estimated to be 1 to 2 persons per 100,000 population in Europe with a higher male-to-female ratio. Erythroderma may present at birth, develop acutely or insidiously (due to progression of an underlying primary pathology, including malignancy). Whilst there is a broad range of diseases that associate with erythroderma, the vast majority of cases result from pre-existing and chronic dermatoses. In part one of this two part concise review, we explore the underlying causes, clinical presentation, pathogenesis and investigation of erythroderma, and suggest potential treatment targets for erythroderma with unknown causes.

Background Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper‐covered area. Topical skin barrier repair cosmetic products are the mainstay treatment to cure and/or prevent DD. Aims To assess the efficacy/tolerability of a zinc gluconate‐taurine/zinc oxide and panthenol/ glycerin/ Butyrospermum parkii butter barrier cream using clinical evaluation. Methods In this prospective, open‐label trial, 20 patients (10 infants/10 adults), with mild/moderate DD enrolled at the Dermatology University Clinic of Catania (Italy) were instructed to apply the cream twice daily for 30 days. Degree of erythema was performed clinically by a 5‐point severity scale (from 0 = no erythema to 4 = severe erythema), at baseline, at 15 and 30 days. An Investigator Global Assessment (IGA) using a 6‐point scale (from −1 = worsening to 4 = complete response/clear) along with product tolerability was also performed at 15 and 30 days. Statistical analysis was performed using SAS version 9. Results At 15 days, a reduction of clinical erythema assessment (CEA) from baseline was observed (mean from 3.2 ± 0.8 to 2.5 ± 0.3; p

Background Cosmetic Skin Delivery has a very important impact on the action of cosmetics. More and more cosmetic manufacturers are focusing on cosmetic delivery. Meanwhile, it also brings safety issues and the customization of national laws and regulations. Objectives This paper reviews the theoretical knowledge about cosmetic skin delivery and evaluation methods. Methods An extensive literature search was conducted using PubMed, Web of Science, and other databases for articles on transdermal/skin delivery in cosmetics from 1985 to 2020. Results The importance of skin delivery in cosmetics is outlined. The structure of the skin and the skin barrier, including delivery pathways available to cosmetic molecules in three modalities are introduced. The laws and regulations of various countries on nanomaterials for cosmetics are listed. The in vitro skin absorption test methods for cosmetics are briefly reviewed. Furthermore, the prospect of future skin penetration methods for cosmetics is presented. Conclusions Currently, various methods to enhance and evaluate cosmetic delivery through skin are available. However, there are no unified domestic and international laws and regulations about evaluation of transdermal delivery. This article provides a new perspective on the development of novel permeation enhancement technologies.

Background Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by pruritus, xerosis, and skin barrier dysfunction. Skin barrier alteration is associated with an increase in trans-epidermal water loss (TEWL) and reduction in skin hydration. Dupilumab is a monoclonal antibody targeting interleukin-13 modulating pro-inflammatory signal transduction, which has been approved for moderate to severe AD. The aim of this study is to evaluate the effects of Dupilumab on skin barrier functions, using non-invasive instruments and clinical evaluation. Materials and methods Thirty patients affected by moderate-severe AD, who had been administered dupilumab, were evaluated by clinical examination and through the instrumental measurements of TEWL and corneometry at the baseline (T0) and 8 weeks (T1) on lesional skin. The clinical evaluation was performed using the Eczema Area and Severity Index (EASI) score. Moreover, a Dermatology Life Quality Index (DLQI) and 7-day numeric rating scale (NRS) questionnaires were administered to each patient. Results The instrumental parameters of skin barrier recovery confirmed the clinical improvement outcomes with a statistically significant reduction of TEWL at T1. Conclusion Our data confirm the clinical outcomes already reported in the literature and show that there was an inverse proportional correlation between TEWL levels and clinical severity after 8 weeks of treatment with dupilumab.

Skin and soft tissue infections are common in diabetics. Diabetic foot infection usually results from disruption of the skin barrier, trauma, pressure, or ischemic wounds. These wounds may become secondarily infected or lead to development of adjacent soft tissue or deeper bone infection. Clinical assessment and diagnosis of these conditions using a multidisciplinary management approach, including careful attention to antibiotic selection, lead to the best outcomes in patient care.

The aim of this study was to examine the effects of carba cyclic phosphatidic acid (ccPA) on cornified envelope (CE) formation and keratinocyte differentiation. ccPA-treated keratinocytes showed higher mRNA and protein levels of differentiation markers and CE components than untreated cells. These results suggest that ccPA could serve as therapeutic targets for treating skin barrier dysfunction because of their roles in upregulating genes and proteins associated with CE formation and keratinocyte differentiation.

Background Pathophysiology of rosacea is not completely understood and involves a complex interaction among genetics, ultraviolet (UV) light, microorganisms, impaired skin barrier, neuronal and vascular dysfunction, and immune system disruption. Aims To describe the etiology of rosacea with an emphasis on the role of UV radiation and exposome, and to review the importance of non‐pharmacologic strategies focusing on photoprotection. Methods We conducted a narrative review of the literature. We performed literature searches with PubMed from January 1990 to November 2020 using the keywords “rosacea”, “pathogenesis”, “ultraviolet radiation”, “exposome”, “photoprotection”, “sunscreens” and “non‐pharmacologic agents”. The search was limited to English, Spanish, and French language articles. Results Several environmental factors such as UV light, diverse microorganisms, air pollution, tobacco smoking, nutrition, and psychological stress showed to trigger or worsen rosacea. UV radiation was reported to induce pro‐inflammatory, pro‐angiogenic, and pro‐fibrotic responses. We found 6 original articles about the impact of sunscreens on rosacea. The use of sunscreens containing ingredients with emollient, anti‐inflammatory, and/or vasoregulatory properties was shown to significantly improve symptomatology. Conclusion UV radiation and the exposome play a key role in the development of rosacea. UV light is implicated in all significant aspects of rosacea: skin inflammation, neoangiogenesis, telangiectasia, and fibrosis, and may even initiate rosacea. While the use of sunscreens is widely recommended, the literature on the impact of photoprotection in rosacea is scarce. Adequately formulated sunscreens could not only provide the required level of photoprotection, but may also help to mitigate the barrier dysfunction, neutralize facial redness (tinted sunscreens), and decrease inflammation and vascular dysfunction.

Transdermal drug delivery is an attractive route for dermatological disease therapy because it can directly target the lesion site on the skin, reduce adverse reactions associated with systemic administration, and improve patient compliance. However, the stratum corneum, as the main skin barrier, severely limits transdermal drug penetration, with compromised bioavailability. Microneedles (MNs), which are leveraged to markedly improve the penetration of therapeutic agents by piercing the stratum corneum and creating hundreds of reversible microchannels in a minimally invasive manner, have been envisioned as a milestone for effective transdermal drug delivery, especially for superficial disease therapy. Here, the emergence of versatile MNs for the transdermal delivery of various drugs is reviewed, particularly focusing on the application of MNs for the treatment of diverse skin diseases, including superficial tumors, scars, psoriasis, herpes, acne, and alopecia. Additionally, the promises and challenges of the widespread translation of MN-mediated transdermal drug delivery in the dermatology field are summarized.

Background: Severe burns lead to a profound hypermetabolic, hypercatabolic, hyper-inflammatory state. Pediatric burn patients are at significantly increased risk for infection and sepsis secondary to loss of the skin barrier and subsequent immunosuppression. Infection is the most common cause of morbidity and death in pediatric burn patients, and the mortality rate from sepsis remains high. Methods: Review of pertinent English-language literature pertaining to infection among pediatric burn patients. Results: Established risk factors for infection in pediatric burn patients are the depth of injury, presence of inhalation injury, indwelling devices, and total body surface area burned. Total body surface area remains one of the most important risk factors for the development of infectious complications, and mortality risks increase significantly if the burn size is >40%. The predominant colonization of burn wound starts with gram-positive organisms, which are replaced later by gram-negative organisms. Most cases of sepsis in burn patients originate from infected burn wounds. Treatment options include topical and systemic antimicrobial drugs, but surgical intervention often is the most definitive treatment. Excision of burn eschar to remove the source of potential infection is a key component of the treatment as well as prevention of infection. Conclusion: Key principles in improving outcomes for septic pediatric burn patients is early recognition, resuscitation, and adherence to management strategies such as prompt antimicrobial drug administration and source control.

Background Chronic pruritus dramatically disrupts quality of life, impairs sleep, and is difficult to treat. The pathogenesis and severity of chronic itch can vary significantly with race. Black skin has inherent structural and molecular characteristics that exacerbates pruritus, leading to unique presentations of pruritic conditions and added challenges in finding effective therapies. The aim of this review is to discuss structural variances in black skin, the subsequent epidemiological disparities in chronic pruritic conditions, and clinical management pearls for the management of itch in black patients. Methods Current literature including mechanistic, translational, and epidemiological data on racial differences in pruritus focusing on black skin were reviewed in Pubmed. Findings Black skin has several unique structural properties related to the pathogenesis of pruritus, including increased trans-epidermal water loss, decreased ceramide levels, lower pH in the stratum corneum, and increased size of mast cells. Black patients consequently are disproportionately affected by chronic pruritic disorders including atopic dermatitis, prurigo nodularis, HIV-related pruritic dermatoses, and cutaneous T-cell lymphoma. Conclusion Pruritus and chronic pruritus disorders disproportionately affects black patients. Management of pruritus of special importance in black patients includes low pH skin care products to protect the skin barrier along with emollients to diminish trans-epidermal water loss. Further mechanistic studies are needed to characterize racial differences in biomarkers and therapeutic targets of chronic itch.

Objective To evaluate the use of a novel skin barrier protectant in a patient treated with radiotherapy for vulvar cancer. Methods This case report was conducted in a radiotherapy department with two women undergoing radiotherapy for vulvar carcinoma. A novel skin barrier protectant was evaluated in one patient; the other underwent the institutional standard skin care protocol. Skin reactions and pain were evaluated using the Radiotherapy Oncology Group Criteria. Main results The patient who was treated with the skin protectant showed accelerated healing toward the end of radiotherapy, and this was accompanied with a decrease in pain (maximum pain score 6/10). In comparison, the patient treated with the standard skin care protocol had an extended healing process, experienced a higher pain level (maximum pain score 9/10), and required more nursing care. Conclusions This case report is the first to suggest that this novel skin barrier protectant could effectively manage acute radiodermatitis in patients with cancer. This case report hopes to lay the foundation for future randomized controlled trials with a larger and broader patient population.

Contains fulltext : 235374.pdf (Publisher’s version ) (Open Access) BACKGROUND: Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) provide useful information about skin barrier function. This study aimed to determine the value of GPSkin Pro, a new handheld device determining both SCH and TEWL, to measure skin barrier impairment and to monitor barrier function in rosacea in daily practice. MATERIALS AND METHODS: Two pilots were performed. Pilot 1: in 27 healthy participants, GPSkin SCH and TEWL were compared to Aquaflux(®) and Epsilon(®) values at the forearm before and after skin barrier perturbation via tapestripping. Moreover, GPSkin values were measured at both cheeks without intervention. Pilot 2: in 16 rosacea patients, GPSkin measurements were performed at the forearm, and at both cheeks before and during anti-inflammatory treatment. They were compared to clinical symptoms and to GPSkin values from pilot 1. RESULTS: Pilot 1: after merging data from before and after tapestripping, a strong correlation was observed between GPSkin TEWL and Aquaflux(®) (R(s) = 0.9256), and GPSkin SCH and Epsilon(®) (R(s) = 0.8798). Pilot 2: SCH was significantly lower at the cheeks of rosacea patients compared to controls, with a normalizing trend during successful treatment. TEWL was comparable among patients and controls and did not change during treatment at all locations. CONCLUSION: The GPSkin determines TEWL and SCH accurately in healthy and impaired skin barrier state and can monitor skin barrier function in rosacea during treatment. The GPSkin device is much more practical compared to previous skin barrier tools when used in clinical practice. Its further validation in other inflammatory skin diseases is recommended.

Skin lipids are essential in every compartment of the skin where they play a key role in various biological functions. Interestingly, their role is central in the maintenance of hydration which is related to skin barrier function and in the skin structure through adipose tissue. It is well described today that skin lipids are affected by ageing giving skin sagging, wrinkles and dryness. Thereby, developing cosmetic actives able to reactivate skin lipids would be an efficient ant-ageing strategy. Due to the strong commitment of our scientists to innovate responsibly and create value, they designed a high value active ingredient named here as Vetiver extract, using a ground-breaking upcycling approach. We evidenced that this unique extract was able to reactivate globally the skin lipids production, bringing skin hydration and plumping effect for mature skin.In order to demonstrate the global renewal of lipids, we evaluated the lipids synthesis on cutaneous cells that produce lipids such as keratinocytes, sebocytes and adipocytes then on Reconstructed Human Epidermis and skin explants. We evaluated the expression of proteins involved in ceramides transport and barrier cornification. We then evaluated hydration and sebaceous parameters on a panel of mature volunteers.We firstly demonstrated that Vetiver extract induced sebum production from human sebocytes cells lines but also improved its quality as observed by the production of specific antimicrobial lipids. Secondly, we demonstrated that Vetiver extract was able to restore skin barrier with the increase of skin lipids neosynthesis on Reconstructed Human Epidermis and skin explants. We also evidenced that Vetiver extract stimulated the lipids transport and epidermal cornification. Finally, Vetiver extract showed a significant effect on adipogenesis and maturation of adipocytes at in vitro and ex vivo models. We confirmed all these activities by showing that Vetiver extract improved sebum production and brought hydration through an increase of lipids content and their conformation. Vetiver extract induced an improvement of skin fatigue and a plumping effect by acting deeply on adipose tissue.In conclusion, we developed an active ingredient able to bring anti-ageing effect for mature skin by a global increase of skin lipids.Les lipides de la peau sont essentiels dans chaque compartiment de la peau où ils jouent un rôle clé dans diverses fonctions biologiques. Il est intéressant de noter que leur rôle est central dans le maintien de l'hydratation, liée à la fonction de barrière cutanée, mais aussi dans la structure même de la peau, par le biais du tissu adipeux. Il est bien décrit aujourd'hui que les lipides de la peau sont affectés par le vieillissement, ce qui entraîne un relâchement de la peau, des rides et une sécheresse. Ainsi, le développement d'actifs cosmétiques capables de réactiver les lipides de la peau serait une stratégie efficace de lutte contre le vieillissement. En raison de l'engagement fort de nos scientifiques à innover de manière responsable et à créer de la valeur, ils ont conçus un ingrédient actif à forte valeur ajoutée, appelé ici extrait de Vétiver, en utilisant une approche révolutionnaire de « up-cycling ». Nous avons démontré que cet extrait unique était capable de réactiver globalement la production de lipides de la peau, apportant une hydratation de la peau et un effet repulpant pour les peaux matures. MÉTHODES: Afin de démontrer le renouvellement global des lipides, nous avons évalué la synthèse des lipides sur les cellules cutanées qui produisent des lipides tels que les kératinocytes, les sébocytes et les adipocytes, puis sur un modèle d’Epiderme Humain Reconstruit et les explants de peau. Nous avons évalué l'expression des protéines impliquées dans le transport des céramides et la kératinisation de la barrière cutanée. Nous avons ensuite évalué l'hydratation et les paramètres sébacés sur un panel de volontaires matures. RÉSULTATS: Nous avons tout d'abord démontré que l'extrait de Vétiver induit la production de sébum à partir de lignées cellulaires de sébocytes humains mais améliore également sa qualité comme l'indique la production de lipides antimicrobiens spécifiques. Ensuite, nous avons démontré que l'extrait de Vétiver était capable de restaurer la barrière cutanée grâce à l'augmentation de la néosynthèse lipidique sur un modèle d’Epiderme Humain Reconstruit et sur des explants de peau. Nous avons également démontré que l'extrait de Vétiver stimulait le transport des lipides et la kératinisation de l'épiderme. Enfin, l'extrait de Vétiver a montré un effet significatif sur l'adipogenèse et la maturation des adipocytes dans des modèles in vitro et ex vivo. Nous avons confirmé à l’échelle clinique toutes ces activités en montrant que l'extrait de Vétiver améliorait la production de sébum et apportait une hydratation grâce à une augmentation de la teneur en lipides ainsi qu’une modification de leur conformation. L'extrait de Vétiver a induit une amélioration de la fatigue cutanée et un effet repulpant en agissant en profondeur sur le tissu adipeux.En conclusion, nous avons développé un ingrédient actif capable d'apporter un effet anti-âge aux peaux matures par une augmentation globale des lipides de la peau.

Objective Vitamin C and peptides are widely used in cosmetic products but there is a paucity of clinical studies showing that the formulations are effective in treating signs of facial ageing. These 3 clinical studies evaluated the effectiveness of an anti‐ageing formula containing natural vitamin C (10%), biopeptides (rice and lupin), hyaluronic acid, and Vichy volcanic mineralising water, in amber glass ampoules with no preservatives (Peptide‐C ampoules). Methods Dansyl chloride fluorescence labelling compared cell turnover for Peptide‐C ampoules vs untreated skin in 32 female subjects. Study 2, an open clinical study, evaluated the efficacy on wrinkles of Peptide‐C ampoules by investigator clinical scoring based on Dynamical Atlas visual assessment (N = 40) and subject self‐assessment questionnaires (N = 47). Study 3, an open clinical study, evaluated wrinkles by instrumental quantification with 3D fringe projection analysis (N = 40) and subject questionnaires (N = 51). Results The mean cell turnover was faster for skin treated with Peptide‐C ampoules compared to untreated skin (17.1 days vs. 19.2 days; P, A formulation containing peptides and vitamin C, in innovative packaging allowing a minimalist formula, demonstrated effectiveness and high subject satisfaction for wrinkle reduction and skin rejuvenation.

Purpose To investigate the effects of various types of Dead Sea mud (DSM) on skin barrier properties over a period of four weeks. Methods The effects of a 4-week application of three types of DSM (as is mud, mud with extra Dead Sea salt, and over the shelf mud) on the barrier properties of normal skin were investigated. Preparations were applied onto forearms of healthy volunteers every other day for 4 weeks, and skin hydration, transepidermal water loss (TEWL), melanin, erythema level, skin pH, skin elasticity, dermal thickness, and collagen content were measured at predefined circular areas on subjects' forearms at baseline, week 1, week 2, and week 4 during the treatment phase and on week 5 following a 1-week regression period in which no mud was applied. Results The use of DSM for 4 weeks was well tolerated with no noticeable changes in TEWL, skin pH, melanin, and erythema levels. A slight firming effect was observed in the forearms treated with salted DSM. Skin hydration was not significantly affected by any type of DSM. However, a slight drying effect of "as is" and "salted" DSM and slight hydration effect of "over the shelf" DSM were observed. This effect could be attributed to the content of DSM rather than to disruption of skin integrity as confirmed by TEWL values. Conclusion Long-term use of all types of DSM did not compromise the barrier integrity of the skin. This provides dermatologists with needed information on safety of DSM and lack of skin disruption activity upon long-term use.

Recent developments of molecular biology have revealed diverse mechanisms of skin diseases, and precision medicine considering these mechanisms requires the frequent objective evaluation of skin phenotypes. Transepidermal water loss (TEWL) is commonly used for evaluating skin barrier function; however, direct measurement of TEWL is time-consuming and is not convenient for daily clinical practice. Here, we propose a new skin barrier assessment method using skin images with topological data analysis (TDA). TDA enabled efficient identification of structural features from a skin image taken by a microscope. These features reflected the regularity of the skin texture. We found a significant correlation between the topological features and TEWL. Moreover, using the features as input, we trained machine-learning models to predict TEWL and obtained good accuracy (R2 = 0.524). Our results suggest that assessment of skin barrier function by topological image analysis is promising.

Congenital ichthyoses are a very heterogeneous group of diseases manifested by dry, rough and scaling skin. In all forms of ichthyoses, the skin barrier is damaged to a certain degree. Congenital ichthyoses are caused by various gene mutations. Clinical manifestations of the individual types vary as the patient ages. Currently, the diagnosis of congenital ichthyoses is based on molecular analysis, which also allows a complete genetic counseling and genetic prevention. It is appropriate to refer the patients to specialized medical centers, where the cooperation of a neonatologist, a pediatric dermatologist, a geneticist and other specialists is ensured.

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by erythematous lesions, pruritus, and a skin barrier defect. Long-term treatment in children is challenging, as there is only one Food and Drug Administration-approved systemic medication. Current treatments may have limited efficacy or serious side effects in children. With a deeper understanding of AD pathogenesis and the advent of target-specific medications, several biologics are undergoing clinical trials for future use in pediatric AD. Areas covered: This article reviews the current and emerging biologic therapies for treatment of pediatric AD. It allows for comprehensive comparison of medications and their clinical trials to help providers optimize patient treatment plans while providing expert insight into upcoming advancements in the treatment of pediatric AD. Expert opinion: Treating pediatric AD is complicated given the variety of disease severity, psychosocial impact, and relative lack of approved medications for severe disease. Given the safety data on dupilumab, newer biologics will likely be second-line. We do not yet understand the long-term impact of newer biologics on an immature immune system, nor do we fully understand their risks and toxicities. We should proceed optimistically, yet cautiously, with the study of biologics in children.

Background The non-invasive skin barrier measurements transepidermal water loss, stratum corneum hydration and the skin surface pH are widely used in clinical skin research. Relative and absolute measurement errors of these measurements are unknown in geriatric care settings. Material and methods Transepidermal water loss, stratum corneum hydration, skin surface pH and temperature were measured on the volar forearm and lower leg twice by trained raters within a cross-sectional study in ten nursing homes. Intrarater reliability was calculated using the ICC (1,1). Intrarater agreement was analyzed using Bland Altman Plots with limits of agreement. Results Two hundred twenty-three residents were included and mean age was 84.2 years. The highest ICC was found for transepidermal water loss and skin surface temperature of the leg with 0.95 (95% CI 0.93 to 0.96). The ICC of the stratum corneum was 0.91 (95% CI 0.88 to 0.93) for both investigated skin areas. The measurement of the pH at the lower leg had the lowest ICC with 0.73 (95% CI 0.66 to 0.78). Highest limits of agreement of approximately 8 a.u. were calculated for stratum corneum hydration and lowest limits of agreement of approximately 1 °C were calculated for skin surface pH. Conclusion Relative measurement errors of transepidermal water loss and stratum corneum hydration were very low indicating that single measurements provide reliable estimates in this population and setting. However, the absolute measurement errors were high for both of these parameters. To increase reliability of skin surface pH we recommend at least two repeated measurements.

Identify, summarise and present key recommendations published in the literature to prevent skin damage in health professionals as a result of personal protective equipment (PPE) during the covid-19 pandemic.A scoping review, based on the Joanna Briggs Institute guidelines, was carried out between December 2019 and May 2020. The studies included male and female health professionals, who wore PPE during the global pandemic, in any given scenario. Headings and abstracts were analysed. Two independent investigators reviewed the full text.Eight publications were included. All of them focused on preventing pressure ulcers (PU) caused by PPE. Hygiene, hydration and the use of skin barriers were highlighted as preventive measures. There were different views around the type of humectant/skin barrier recommended to avoid skin damage.More studies identifying the most suitable strategies to maintain health professionals' skin integrity during the covid-19 pandemic are needed.Identificar, resumir y presentar las recomendaciones publicadas para prevenir lesiones cutáneas (cualquier alteración de la piel) por el uso de productos y equipos de protección personal (EPP) en profesionales de la salud durante la pandemia del COVID-19.Se realizó una revisión de alcance, basada en las sugerencias del Instituto Joanna Briggs, entre diciembre de 2019 y mayo de 2020. Se incluyeron estudios realizados con profesionales de la salud de ambos sexos, que utilizaron productos y EPP durante la pandemia, en cualquier escenario de la atención sanitaria. Se examinaron los títulos y resúmenes de los estudios. Dos revisores independientes evaluaron el texto completo, según los criterios de inclusión establecidos.Ocho publicaciones fueron seleccionadas. Todas se centraron en los cuidados relacionados con la prevención de lesiones por presión (LPP). Resaltaron la higiene e hidratación, y el uso de protectores cutáneos como medidas preventivas.Es necesario llevar a cabo investigaciones en busca de mejores estrategias para mantener la integridad de la piel de los profesionales de la salud en el ejercicio de su profesión durante el COVID-19.Este artículo es parte de un proyecto apoyado por el Ministerio de Ciencia, Tecnología e Innovaciones (MCTI) y el Consejo Nacional de Desarrollo Científico y Tecnológico (CNPq) de Brasil.

Objective To examine and compare different methods of dressing change on skin tears at the periductal wound for ICU patients with central venous catheterization (CVC). Methods This research used a quasi-experimental design. Participants included 98 patients from the ICU of a medical center in Taiwan using a convenience sampling technique from April 1, 2017 to March 31, 2018. Results Applying skin barrier film at the CVC insertion site effectively protected the skin and significantly reduced the risk of skin tears among ICU patients (P Conclusions This study showed that use of skin barrier film at the site of CVC insertion can increase skin strength, maintain skin integrity, and decrease the incidence of skin tears. Skin barrier film is thus recommended for routine use in peripheral skin care for patients receiving CVC.

Introduction Skin provides critical barrier properties that enable terrestrial life. Myriad research has focused on the "water barrier" to transepidermal water loss (TEWL) despite there being a multitude of skin barrier properties. We asked what other barrier properties may have been overlooked and compiled data demonstrating the "electrolyte barrier" to be of potential clinical relevance. Methods A literature search was conducted through PubMed, Embase, Google Scholar, and Web of Science databases for the following keywords: "transepidermal" or "epidermal" or "cutaneous" or "skin" or "percutaneous" and "ion" or "sodium" or "chloride" or "potassium" or "electrolyte" and "flux" or "egression." Textbooks at the University of California, San Francisco were also hand reviewed. Experimental studies quantifying in vivo or ex vivo percutaneous egression of ions in response to human skin barrier perturbation were included. Results Experimental damage to skin, mostly by tape-stripping, frequently induced increased ion flux rates through the epidermis, in addition to increases in TEWL values. Interestingly, barrier perturbation did not always result in a concomitant rise in TEWL and transepidermal ion flux rates, such as in delipidization, indicating a distinction between the two barriers. Conclusion Quantifying the percutaneous egression of ions in response to physical or chemical alterations may offer additional data that are not to be captured with TEWL studies exclusively. Continued efforts should be made to: (1) advance this technique as a method of assessing skin status and (2) enhance our understanding of other barriers and mechanisms.

BACKGROUND Laser therapies have brought dawn to refractory skin diseases, but also were accompanied by postlaser inflammation and skin barrier dysfunction. To recover skin function quickly, the research and development of active ingredients including β-glucan for postlaser repair have attracted much attention. AIMS To evaluate the efficacy and tolerance of skin care regimens containing β-glucan (Dermdoc®;Songyang Biotech) in repairing postlaser inflammation and skin barrier dysfunction after fractional laser therapy. METHODS A total of 20 patients with facial atrophic acne scars who accepted fractional laser therapy were recruited: 10 patients treated with ablative fractional CO2 laser and 10 patients treated with 1565nm nonablative fractional laser. Using the method of split-face vehicle-control study, the left half of the face was served as the treatment side and accepted skin care regimens, and the right half was control side accepted vehicle. Noninvasive bioinstrumentation of skin hydration index, transepidermal water loss (TEWL), and hemoglobin index (E value) was detected in the study. Standard digital photographs were taken at each visit. The skin tolerance and adverse effect were also evaluated by subject questionnaire. RESULTS Compared with the control side, the Hemoglobin index (E value) of the treatment side was improved more significantly on the 7th day (P

Background Acne is the most common dermatological disorder. An impaired barrier function in acne vulgaris has been reported, as well as decreased amounts of epidermal ceramides. Also, many of the systemic and topical medications prescribed for the treatment of acne exacerbate these skin barrier disruptions and can lead to irritation and dry skin conditions. Aim The review explored the importance of maximizing adjunctive skincare, such as over-the-counter products for managing acne and avoiding adverse effects. Methods A literature review was conducted and included clinical acne guidelines, clinical studies, and review articles on acne prevention, treatment, and maintenance. Searches were made in PubMed and Google Scholar for English-language literature published between Jan 1, 2010, and Apr 1, 2020. Two clinicians manually reviewed selected publications. Results Seventy-four articles were included in the analyses. A variety of specialized cleansers and moisturizers are available as suitable adjunctive therapies for acne-prone skin. Lipid-free cleansers were found to be the most appropriate type of cleanser for acne-prone skin as they were associated with a low risk of skin irritation, and a near-physiological stratum corneum pH. Moisturizers typically included ingredients such as humectants, emollients, oil absorbers, and those with anti-inflammatory and/or barrier replenishing properties. Given the various adjunctive products available, decision frameworks were created for clinicians to use when selecting over-the-counter cleansers and moisturizers for acne-prone patients. Conclusion Informing clinicians about skin barrier dysfunction in acne and the benefits of adjunctive skincare may help them to choose the right product(s) to complement prescription therapy. J Drugs Dermatol. 2020;19(11): doi:10.36849/JDD.2020.5536.

Background Numerous scholars have reported that inconsistent levels of incubator humidity in the neonatal intensive care unit (NICU) require attention. Evidence synthesis was needed to identify optimal incubator humidity levels and duration to decrease transepidermal water loss (TEWL) and the potential for infection. Purpose The purpose of this systematic review was to appraise and synthesize the evidence of preterm outcomes related to incubator humidity. The primary aim of this study was to determine how patient outcomes were impacted by incubator humidity levels and duration in premature infants born before 320/7 weeks cared for in the NICU. Methods/search strategy The foundation of this systematic review was the Joanna Briggs Institute method for systematic reviews. Mefford's theory of health promotion for the preterm infant was used to address the wholeness of the preterm infant's body system. Evidence was classified using the Johns Hopkins evidence-based practice levels and quality of evidence. Findings Twelve studies met inclusion criteria. The evidence demonstrated that the practice of incubator humidity is warranted; however, it does not come without risks. Microbial growth was increased in high levels of incubator humidity. Unnecessary TEWL was prevented by lowering high levels of incubator humidity after the first week of life, improving skin barrier formation. Implications for practice Incubator humidity of 60% to 70% in the first week of life was effective in preventing TEWL in infants born 26 weeks or more. Implications for research Future incubator humidity research is needed for infants born before 26 weeks.Video Abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=39.

Emulsifier molecules, with their amphiphilic character, are ubiquitous in moisturizing creams and primarily serve to disperse the water-insoluble molecules such as emollients, oils, lipids and fats in water. The objective of this study was to investigate the effect of emulsifier molecules on the barrier and biomechanical properties of human stratum corneum (SC) and to compare the efficacy of emulsifier molecules when used in a fully formulated moisturizing cream.We employed methods based on thin-film mechanics to measure the drying stress and intercellular cohesion in the SC. The emulsifier molecules or moisturizing creams formulated with them were applied to a fully hydrated SC adhered to a glass substrate. In-plane stress developed in the SC during drying was then measured by tracking changes in the curvature of the glass substrate. The intercellular cohesion within the SC was measured by means of a double cantilever beam (DCB) set-up, where the treated or untreated SC was sandwiched between two substrates, and the delamination energy calculated by measuring the force required to drive a crack through the SC. Moisturizing cream diffusivity through the stratum corneum was measured by spectroscopic technique and related to internal SC stress and fracture energy.We observe significant differences in the biomechanical behaviour of SC when moisturizing creams with different emulsifier molecules are applied on isolated stratum corneum ex vivo. The reduction in maximum stress varied between 12% and 26% depending on the emulsifier molecules used in the formulation. The intercellular cohesion and the diffusion of molecules in the formulated moisturizing creams through the SC were also found to be strongly dependent on the type of emulsifier molecule used in the formulation.The biomechanical and barrier properties of the human stratum corneum show strong dependence on the emulsifier molecule used in the moisturizing creams, even when the creams included only ~3 weight% emulsifier molecules. Moreover, we found that the reduction in SC peak stress was strongly correlated with the formulation diffusivity into the SC. The moisturizing creams diffusing fastest into the SC had the largest reduction in peak stress and vice versa.Les molécules d’émulsifiant, avec leur caractère amphiphile, sont omniprésents dans les crèmes hydratantes et servent principalement à disperser dans l’eau les molécules hydro insolubles telles que les émollients, les huiles, les lipides et les graisses. L’objectif de cette étude était d’étudier l’effet des molécules d’émulsifiant sur les propriétés barrières et biomécaniques de la couche cornée humaine (stratum corneum, SC), et de comparer l’efficacité des molécules d’émulsifiant lorsqu’elles sont utilisées dans une crème hydratante intégralement formulée. MÉTHODES: Nous avons employé des méthodes basées sur des propriétés mécaniques de couches minces pour mesurer le stress de dessèchement et la cohésion intercellulaire dans le SC. Les molécules d’émulsifiant ou les crèmes hydratantes formulées avec ces molécules ont été appliquées sur un SC entièrement hydraté collé à un substrat de verre. Le stress dans le plan développé dans le SC pendant le dessèchement a été mesuré en suivant les changements de courbure du substrat de verre. La cohésion intercellulaire au sein du SC a été mesurée au moyen d’une configuration de faisceau à double cantilever (DCB), où le SC traité ou non traité a été placé entre deux substrats, et l’énergie de délamination calculée en mesurant la force nécessaire pour entrainer une fissure dans la couche cornée. La diffusivité de la crème hydratante dans la couche cornée a été mesurée par la technique spectroscopique, et était liée à l’énergie interne du stress et de la fracture SC. RÉSULTATS: Nous observons des différences significatives dans le comportement biomécanique du SC lorsque des crèmes hydratantes avec différentes molécules d’émulsifiant sont appliquées sur une couche cornée isolée ex vivo. La réduction du stress maximal variait entre 12 % et 26 % en fonction des molécules d’émulsifiant utilisées dans la formulation. La cohésion intercellulaire ainsi que la diffusion des molécules dans les crèmes hydratantes formulées par le biais du SC se sont également révélées fortement dépendantes du type de molécule d’émulsifiant utilisée dans la formulation.Les propriétés biomécaniques et barrières de la couche cornée humaine montrent une forte dépendance à la molécule d’émulsifiant utilisée dans les crèmes hydratantes, même lorsque ces crèmes contenaient uniquement plus ou moins 3% de molécules d’émulsifiant. De plus, nous avons constaté que la réduction du stress maximal était fortement corrélée à la diffusivité de la formulation dans le SC. Les crèmes hydratantes qui se diffusent le plus rapidement dans le SC avaient la plus grande réduction du stress maximal et vice versa.

Objective The impact of hair removal on the biophysical and biochemical characteristics of human axillary skin is not fully understood. This study investigated the effect of different hair‐removal techniques on biophysical parameters and the concentrations of key inflammatory biomarkers in the axillae of female Thai subjects. Axillary hair was removed by shaving, plucking or waxing. Methods Following a 2‐week washout phase without hair removal, subjects underwent visual assessment for erythema and skin dryness in one (randomized) axilla, then, hair was removed from the axilla by shaving, plucking or waxing according to each subject’s established habit. Erythema and dryness were assessed again 30 min after hair removal, and buffer scrubs collected from depilated and non‐depilated axillae and analysed for inflammatory cytokines; after a further 48 h, erythema, dryness and post‐inflammatory hyperpigmentation (PIHP) were assessed in the depilated axilla. Biophysical assessments (skin hydration, barrier integrity, elasticity and roughness) were made in depilated and non‐depilated axillae. Results All three hair‐removal techniques induced an increase in axillary erythema and skin dryness. Shaving was associated with significantly less erythema (P, This study investigated the effect of different hair‐removal techniques (shaving, plucking or waxing) on biophysical parameters and the concentrations of key inflammatory biomarkers in the axillae of female Thai subjects. Although all three techniques induced an increase in axillary erythema and skin dryness, shaving was associated with significantly less erythema, but significantly greater skin dryness compared with the other techniques. Furthermore, the concentration of interleukins IL‐1α and IL‐1RA increased following hair removal by each technique.

Background Melasma is a common skin disorder. Nd:YAG laser toning is a popular treatment for melanin clearance. Treatment efficacy is limited by factors such as presence of reactive oxygen species, DNA damage, TEWL, and skin barrier disruption. Aims The purpose of this pilot study is to explore the efficacy of a non-crosslinked hyaluronic acid with anti-oxidant ingredients in mitigating the above-stated factors in the treatment of melasma using Nd:YAG laser toning. Method In this pilot retrospective study of six cases with melasma, Nd:YAG laser toning was performed for each case until improvement of melasma has plateaued (after 4-6 sessions) and at which point treatment was paused. After injecting non-crosslinked hyaluronic acid (9-12 mL) with anti-oxidant ingredients into the face with focus on the lesional skin, further sessions (4-6) of Nd:YAG laser toning was resumed. Before, interim (improvement has plateaued), and after (on completion of the remaining sessions of laser toning after hyaluronic acid injection) photos of the six cases were scored using modified MASI. ANOVA analysis was applied to the scores. Results All six melasma cases had further improvement in melasma clearance after hyaluronic acid injection beyond the point when improvement has plateaued. ANOVA analysis of before, interim, and after scores showed statistical significance in difference between the three groups. Conclusion This pilot study of six cases suggests that the use of a non-crosslinked hyaluronic acid with anti-oxidants may improve the efficacy of Nd:YAG laser toning in the treatment of melasma.