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Sophie Mac-Mary,1 Itziar Zornoza Solinis,2 Océane Predine,1 Jean-Marie Sainthillier,1 Christelle Sladen,2 Mike Bell,2 Mark O’Mahony2 1Skinexigence, Besançon, France; 2Walgreens Boots Alliance, Nottingham, UKCorrespondence: Sophie Mac-MarySkinexigence SAS, 2 Rue Paul Milleret, 25000, Besançon, FranceTel +33 3 81 88 95 51Email smac@skinexigence.comBackground: The aetiology of infraorbital dark circles is complex and multi-factorial. The aim of this research was to measure and characterize dark circles and to determine the physiological changes associated with the occurrence of this aesthetically unpleasing issue.Materials and methods: Clinical, photographic and instrumental assessments were performed on Caucasian skin to determine the most appropriate methodologies to measure dark circles, comparing different zones of the infraorbital region in subjects with and without dark circles. Exploratory studies were also carried out on African and Far East Asian skin, as well as on tracking the natural variation of dark circles over seven days in Caucasian subjects.Results: Under-eye dark circles in Caucasian subjects are characterized by significantly darker coloured skin and higher colour deviations between the dark circle region and surrounding areas of skin. Multispectral image analysis produced a higher melanin index in subjects with dark circles, suggesting hyperpigmentation in the affected area, in addition to a higher haemoglobin index. The higher haemoglobin index, combined with preliminary assessments of the vascular network by videocapillaroscopy, suggests there may be more dilated, thicker or increased numbers of capillaries in subjects with dark circles. Ultrasound analysis showed a significant difference in skin thickness between the two groups of subjects linking the appearance of dark circles to thinner skin under the eye. Many of these trends were also observed in African and Far East Asian skin. The results also showed intra-individual, intra-day and inter-day variability of dark circle intensity in subjects with Caucasian skin.Conclusion: Three key physiological factors associated with the occurrence of infraorbital dark circles are hyperpigmentation, a tendency for more dilated, thicker or increased number of capillaries and thinner skin in the under-eye area. The combination of these three factors provides a robust indication of the presence of infraorbital dark circles.Keywords: dark circles, infraorbital, ultrasound imaging, image processing, multispectral imaging, pigmentation

International audience; Skin ageing is a complex process determined by the genetic endowment of individual and environmental factors, such as sun exposure. The effects of skin ageing are mostly encountered in the superficial dermis and in the epidermis. We have previously demonstrated in vivo the beneficial effect of a topically applied formula of 5% vitamin C in the treatment of skin ageing. Another active compound, madecassoside extracted from Centella asiatica, known to induce collagen expression and/or to modulate inflammatory mediators, might thus prevent and correct some signs of ageing. A randomized double-blind study was carried out on photoaged skin of 20 female volunteers to investigate the effects of topically applied 5% vitamin C and 0.1% madecassoside on the clinical, biophysical and structural skin properties. After 6 months of treatment, we observed a significant improvement of the clinical score for deep and superficial wrinkles, suppleness, firmness, roughness and skin hydration. These results were corroborated by measurements of skin elasticity and semi-quantitative histological assessment of the elastic fibre network in the papillary dermis. Two-thirds of the subjects showed an improvement. The re-appearance of a normally structured elastic fibre network was observed. Our results revealed a functional and structural remodelling of chronically sun-damaged skin.

The development of in vivo microdialysis has made it possible to monitor cutaneous free flaps in maxillo-facial surgery. A microprobe inserted in the free flap dermis collects a microdialysate enabling measurement of dermal metabolites such as glucose, lactate, pyruvate, or glycerol. The monitoring curves are predictive of ischemia-related tissue injury. Hourly measurements provide a reliable method for early diagnosis of venous or arterial thrombosis. Revision surgery can then be undertaken if needed to repair microanastomoses before clinical alteration. This technique has been compared with validated flaps monitoring systems such as temperature probe, transcutaneous oxygen tension monitoring, and laser Doppler flowmetry. Microdialysis has several advantages: objective measurements, different curves for venous and arterial thrombosis, early diagnosis. Accessibility to oral cavity or pharyngeal flaps requires careful clinical analysis (microprobe fixation, anatomy and choice of flap).

Summary Background Different noninvasive bioengineering techniques exist to study the microvasculature of the skin and the dynamics of the microcirculation. The goal of these techniques is to visualize the skin capillary circulation easily and directly. Indeed, this information is irreplaceable to study the physiology and physiopathology of the skin capillary circulation efficiently. Aims Capillaroscopy and video-capillaroscopy techniques are presented with different methods to study the capillary structure of the skin. Methods he methods presented in this work include image processing analysis combining morphology, statistics, geometry, and neural network detection designed to quantify the microcirculation and to follow its evolution. To illustrate the combination of these techniques and methods, different examples of their application are described, in dermatology (hypertension, venous insufficiency, age-related changes) as well as in cosmetology (rosacea and erythrosis assessment). Conclusion The determination of structural or dynamic changes in the cutaneous microcirculation belongs to the noninvasive techniques of the biometrological domain. Thus, every capillary modification resulting from topical cosmetic products, or chemical agents can be observed. In pathology, numerous conditions can be better examined with this system. Associated with the potential of numerical image analysis, capillaroscopy techniques will probably extend their application fields to the assessment of the influence of arterial and venous diseases on the skin nutritional circulation.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease in which reactive oxygen species (ROS) may be involved. Iron catalyses ROS formation and ascorbic acid (AA) scavenges these species. Objective: The aim of this work was to determine iron and AA levels in AD patients’ dermis and to compare their concentrations with those of healthy volunteers’ dermis. Methods: Five AD patients and 5 healthy subjects (controls) were enrolled in this study. Iron and AA were collected from human dermis by microdialysis and assessed by atomic absorption spectrometry and gas chromatography-mass spectrometry, respectively. Results: The AD dermis demonstrated higher iron concentrations (44.3 ± 4.6 µg/l) compared to controls (21.8 ± 1.2 µg/l) as well as a significantly lower concentration of AA (46.7 ± 0.6 vs. 176.8 ± 14.5 µg/ml, respectively). Conclusion: These results suggest that iron and AA dermis levels could be indicators of inflammatory tissues and might be implicated in dermatological diseases such as AD.

Objective: To evaluate, in the context of a randomized study, the ‘Sole Si Sole No GISED’ project, the effectiveness of an educational intervention to improve sun protection behaviour in schoolchildren. Methods: A large number of primary schools (classes II and III) in Italy were randomized to an educational intervention or control group: The intervention was conducted by trained teachers using ad hoc developed materials. Attitudes toward sun exposure and behaviour while in the sun were assessed at baseline and 1 year after concluding the educational intervention. In a subgroup of children, melanocytic naevi were counted on the upper limbs at the same intervals. The pilot phase of the study was started in 2001. Results: During the pilot phase, a total of 4,233 children was recruited. Of these, 2,116 were randomized to the active intervention and 2,117 to the control group. No difference for any of the study variables was documented between the 2 groups at baseline. About 20% of the children reported intense sun exposure during the year preceding the study. About 88% of the children reported adequate modalities of sun protection. Sunscreens were commonly used. A total of 508 children (12%) reported a history of sunburns in the year preceding the start of the study. Melanocytic naevi were counted in a total of 1,503 children (852 in the experimental and 651 in the control group). No differences in terms of skin, hair and eye colours were documented between the experimental and the control groups. The mean naevus count at baseline was 9.6 (median 7) in the experimental group and 10.1 (median 8) in the control group. Conclusion: About 50% of the total expected number of children was recruited during the pilot phase of the study. Randomization proved to be an excellent modality to select 2 samples similar for all the important study variables examined. A history of sunburns was reported less frequently than expected. The ‘Sole Si Sole No GISED programme’ is one of the few examples of a controlled evaluation of the effectiveness of an educational intervention in Italy.

International audience; Infestation with head lice is a widespread, persistent, and recurring issue leading to serious health problems if untreated. We are facing resistance phenomena to usual pediculicides and questions about their direct or cumulative toxicity. The aim of this trial was to assess the efficacy of a new product, free of chemical insecticides but with a physical effect. This product contains components whose antilice efficacy has already been demonstrated, as well as Andiroba oil which asphyxiates the lice and Quassia vinegar which dissolves the chitin of the nits (they are then inactivated). 30 patients with head lice infestation, aged 3-39 years, applied the treatment one to three times, 5 days apart. Cure was defined as the absence of live lice after 5, 10, or 14 days, and symptoms are usually associated with infestation. Easiness and safety of the treatment were assessed by the patients and/or their parents. Overall cure rates were 20% on D5 after one treatment, 37% on D10 after two treatments, and 90% on D14 after three treatments. Symptoms such as itch, scalp dryness, redness, and flakiness rapidly diminished. This treatment seems to be a beneficial addition or a valuable alternative to existing treatments, considering the total absence of chemical insecticides, the absence of drug-resistance induction in head lice, the absence of major toxicological risks compared with usual pediculicides, and the favourable patient use instructions.

Nutritional Components (NC) are often under-estimated by dermatologists who neglect them and patients who do not hesitate to use them without thinking of other parallel medication or consumption. This phenomenon has already led to some incidents, such as chronic hypervitaminosis A following retinoid therapy for aging skin and acne. Consequently, the development of new nutritional components now necessitates safety assessments in order to respond to legal requirements but also to improve the knowledge and confidence of professionals and consumers. These studies have to be associated first with bioavailability studies and in vitro studies to improve the understanding of their mechanisms of action, then with clinical studies to demonstrate their efficacy.

Reactive oxygen species play an important role in inflammatory skin diseases such as psoriasis. Reactive oxygen species synthesis is catalysed by iron and some species are scavenged by ascorbic acid. The aim of this work was to assess iron and ascorbic acid in uninvolved and involved psoriatic dermis and to compare the corresponding concentrations in the dermis of healthy subjects. Microdialysis associated with atomic absorption spectrometry and gas chromatography-mass spectrometry was used to assess iron and ascorbic acid, respectively. Seven psoriatic patients and five healthy volunteers were studied. Iron concentrations in the involved (57.1 +/- 19.3 microg/l) and uninvolved (49.7 +/- 27.1 microgl/l) psoriatic dermis were higher than the corresponding value determined in the dermis of healthy subjects (21.8 +/- 2.4 microg/l) (p