EEMCO guidance for the assessment of stratum corneum hydration: electrical methods

The clinical efficacy, safety and functionality of anion textile in the treatment of atopic dermatitis

BACKGROUND

Several previous studies have suggested the improvement of atopic dermatitis (AD) in response to special fabrics. In particular, beneficial effects have been reported, following the use of anion textiles.

OBJECTIVE

The purpose of this study is to evaluate the effectiveness and safety of an anion textile in patients suffering from AD.

METHODS

We compared an anion textile with a pure cotton textile. Fifty-two atopic patients (n=52) were enrolled and divided into two groups. The patients in the test (n=25) and control (n=19) groups wore undergarments made of an anion textile or pure cotton over a period of 4 weeks. The overall severity of disease was evaluated using the SCORing atopic dermatitis (SCORAD) index, whereas, the treatment efficacy was measured using a Tewameter® (Courage & Khazaka, Cologne, Germany), Mexameter® (Courage & Khazaka) and Corneo meter® (Courage & Khazaka).

RESULTS

At the end of the study, a significant decrease in the SCORAD index was observed among the patients with AD in the test group (mean SCORAD decreased from 47.2 to 36.1). Similarly, improvements in the mean transepidermal water loss, skin erythema and stratum corneum hydration were significantly greater among the patients with AD in the test group than in the control group.

CONCLUSION

Anion textiles may be used to significantly improve the objective and subjective symptoms of AD, and are similar in terms of comfort to cotton textiles. The use of anion textiles may be beneficial in the management of patients with AD.

Resveratrol-procyanidin blend: nutraceutical and antiaging efficacy evaluated in a placebocontrolled, double-blind study

Background

Skin is constantly exposed to pro-oxidant environmental stress from several sources, including air pollutants, ultraviolet solar light, and chemical oxidants. Reactive oxygen species have been implicated in age-related skin disorders. Dietary bioactive antioxidant compounds, such as polyphenols, have beneficial effects on skin health. The advantage of a nutritional administration route is that blood delivers nutraceutical bioactive compounds continuously to all skin compartments, ie, the epidermis, dermis, and subcutaneous fat. The purpose of this study was to evaluate the topical and systemic effects of a dietary supplement containing resveratrol and procyanidin on age-related alterations to the skin, the skin antioxidant pool, and systemic oxidative stress levels.

Methods

An instrumental study was performed in 50 subjects (25 treated with supplements and 25 with placebo) to identify clinical features induced by chronoaging or photoaging. Product efficacy was evaluated after 60 days of treatment in terms of in vivo and in situ skin hydration, elasticity, and skin roughness levels, systemic oxidative stress levels by plasmatic derivatives of reactive oxygen metabolites and oxyadsorbent tests, and extent of the skin antioxidant pool.

Results

After 60 days of treatment, values for systemic oxidative stress, plasmatic antioxidant capacity, and skin antioxidant power had increased significantly. Additionally, skin moisturization and elasticity had improved, while skin roughness and depth of wrinkles had diminished. Intensity of age spots had significantly decreased, as evidenced by improvement in the individual typological angle.

Conclusion

Nutraceutical and pharmacological intervention with a supplement characterized by a specific blend of resveratrol and procyanidin may be a promising strategy to support treatments for the reduction of skin wrinkling, as well as reducing systemic and skin oxidative stress.

Atopic dermatitis: correlation between non-damaged skin barrier function and disease activity

BACKGROUND

  Atopic dermatitis (AD) is a chronic dermatosis, predominant in childhood, characterized by pruritus and eczematous-type lesions with xerosis as the prominent clinical sign.

OBJECTIVES

  To analyze the correlation between biophysical measurements of skin barrier function and other assessment criteria of clinical severity according to Rajka and Langeland's criteria.

METHODS

  Biophysical measurements [transepidermal water loss (TEWL) and corneometry] were obtained from 120 patients with the diagnosis of AD. Serum levels of IgE were also evaluated.

RESULTS

  A significant correlation between corneometry, TEWL, and clinical severity of AD was found. Data showed an inverse correlation between corneometry, TEWL, and AD severity, and a significant difference (P < 0.001) between mean of corneometry and TEWL and AD severity (mild, moderate, and severe). As for IgE levels, corneometry had significant negative correlation, in contrast with TEWL, which showed a significant positive correlation (P < 0.001).

CONCLUSION

  Biophysical measurements of skin barrier in non-lesional skin of AD may work as an evaluation factor for AD severity.

Assessing the relationship between vitamin D3 and stratum corneum hydration for the treatment of xerotic skin

Vitamin D₃ has been called the “sunshine” vitamin since the formation of vitamin D is mediated by exposure to sunlight. Vitamin D₃ is linked to many health benefits, however serum levels of vitamin D₃ have been decreasing over the last few decades and the lower levels of vitamin D₃ may have consequences on normal physiology. We investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels and stratum corneum conductance as well as the effect of topical application of cholecalciferol (vitamin D₃) on dry skin. Eighty three subjects were recruited and blood serum levels and skin conductance measurements were taken after a one week washout. A correlation was observed between vitamin D levels and skin moisture content, individuals with lower levels of vitamin D had lower average skin moisture. Subsequently, a 3-week split leg, randomized, vehicle controlled clinical study was conducted on a subset of 61 of the above individuals who were identified with non-sufficient vitamin D serum levels. Topical supplementation with cholecalciferol significantly increased measurements of skin moisturization and resulted in improvements in subjective clinical grading of dry skin. Taken together our finding suggest a relationship between serum vitamin D₃ (25(OH)D) levels and hydration of the stratum corneum and further demonstrate the skin moisture benefit from topical application of vitamin D₃.

Does massage postapplication improve moisturizer's efficacy? A 2-week regression study

BACKGROUND

Combining massage with moisturizer application is a popular technique in beauty spa sessions. The subjective positive psychological effects of massage with moisturizer application in hand and face beauty treatment are documented by many people attending spa sessions. The aim of this study was to objectively evaluate the effect of local effleurage massage as an external intervention on moisturizer efficacy.

METHODS

In a regression-type study of 2-week, twice-daily application followed by 1 week of regression, 13 female subjects applied "off the shelf" moisturizer twice daily on both forearms followed by 1 min superficial massage for one forearm randomized among subjects. The influence of massage after moisturizer application on skin barrier properties was evaluated by noninvasive measurements of transepidermal water loss (TEWL), skin capacitance, and skin elasticity at baseline, day 7, and day 14 during the treatment phase, and day 21 following a 1-week regression period, in which no moisturizer and no massage were performed on forearms.

RESULTS

The tested "off the shelf" moisturizer in both "massage" and "no-massage" application protocols caused a comparable progressive improvement in skin hydration level and barrier permeability over the 2-week treatment period, which was maintained during the 1-week regression (no moisturizer) period. In addition, skin elasticity was similarly improved by both application protocols.

CONCLUSION

In this long-term study, the daily performance of massage after moisturizer application was not an effective external intervention for enhancing moisturizer efficacy.

Influence of skin type, race, sex, and anatomic location on epidermal barrier function

The intact skin represents a barrier to the uncontrolled loss of water, proteins, and plasma components from the organism. Owing to its complex structure, the epidermal barrier with its major layer, the stratum corneum, is the rate-limiting unit for the penetration of exogenous substances through the skin. The epidermal barrier is not a static structure. The status of different functions of the epidermis can be monitored by assessing specific biophysical parameters such as transepidermal water loss, stratum corneum hydration, and skin surface pH. Variables originating from the individual as well as exogenous factors have an important influence on the epidermal barrier parameters.

Methods to Assess the Protective Efficacy of Emollients against Climatic and Chemical Aggressors

Exposure to harsh environmental conditions, such as cold and dry climate and chemicals can have an abrasive effect on skin. Skin care products containing ingredients that avert these noxious effects by reinforcement of the barrier function can be tested using in vivo models. The objective is to use in vivo models to assess the efficacy of emollients in protecting skin against climatic and chemical insults. A first model used a stream of cooled air to mimic cold wind. A second used sodium lauryl sulfate (SLS) under patch as chemical aggressor. In the model with simulated wind exposure, the untreated exposed area had a significant decrease in hydration. In contrast, application of an emollient caused a significant increase in hydration that was maintained after wind exposure. In the second model with SLS exposure, application of a barrier cream before SLS patch significantly reduced the dehydrating effect of SLS with a significant difference in variation between both areas. Application of the cream reduced TEWL, indicative of a physical reinforcement of the skin barrier. The two presented test methods, done under standardized conditions, can be used for evaluation of protective effect of emollient, by reinforcing the barrier function against experimentally induced skin dehydration.

Exploring the effects of non-medical versus medical approaches to the management of skin aging in women over sixty

This study was a pilot project, set up to assess ageing skin using a multi-disciplinary approach. The main aim of this study was to evaluate whether the use of more radical ('medical') treatments in the management of skin ageing would bring superior results and ultimately make people look younger, than the use of cosmetics ('non-medical' treatments). A simple post-hoc study design was used, whereby medical treatments varied within the group, all of them completed at least 2 weeks before the start of the study. In addition, it was of interest to assess the suitability of the proposed combination of methods. A total of 21 female participants were recruited for this study: 11 for the non-medical and 10 for the medical group. The multi-disciplinary approach consisted of instrumental measurements, self-assessment, expert assessment by Merz scales and a public perception survey. The majority of nearly 70 sets of instrumental skin data obtained in this study did not differ significantly between the non-medical and the medical group. However, the medical group gave higher self-assessment scores for their faces. The scores for hands were lower than scores for faces by both groups. This was partly supported by instrumental data (lower skin hydration on hands than on the face). The findings of the public perception survey of nine matched pairs of subjects scored the non-medical group as younger looking. Data analysis has shown that the judgement of youthfulness did not depend on either the gender or the age of observers.

The effects of natural S-equol supplementation on skin aging in postmenopausal women: a pilot randomized placebo-controlled trial

OBJECTIVE

The aim of this study was to investigate the effects of the natural S-equol supplement on skin aging in equol-nonproducing Japanese postmenopausal women.

METHODS

A randomized, double-blind, placebo-controlled trial examined the use of the natural S-equol supplement for 12 weeks in 101 postmenopausal Japanese women who were equol nonproducers. They were randomly assigned to one of three groups: placebo (n = 34), 10 mg S-equol/day (EQL10; n = 34), or 30 mg S-equol/day (EQL30; n = 33). Skin parameters of crow's-feet wrinkles (area and depth), hydration, transepidermal water loss, and elasticity were measured at baseline and at monthly intervals during treatment. Vaginal cytology, endometrial thickness, and mammography were performed before and after treatment. Serum hormone concentrations were measured at the same time as skin parameters.

RESULTS

The EQL10 and EQL30 groups showed significant reductions in wrinkle area compared with the placebo group (P < 0.05). There was a significant difference in wrinkle depth between the placebo group and the EQL30 group (P < 0.05). Other skin parameters did not show significant differences after the treatment in any group. There were no abnormal results in hormone status or gynecological examinations.

CONCLUSIONS

Our data suggest that natural S-equol supplementation (EQL10 and EQL30) may have a beneficial effect on crow's-feet wrinkles in postmenopausal women without serious adverse events.

Ustekinumab biotherapy and real-time psoriasis capacitance mapping: a pilot study

In recent years, the treatment of moderate to severe psoriasis has benefited from the development of targeted biologicals. Assessing this new class of drugs calls for precise modalities of severity/improvement ratings of the disease. Bioengineering-driven dermometrology aims at improving objective and quantitative assessments of disease severity and treatment efficacy. Skin capacitance mapping/imaging is one of those emerging methods. Among its clinical applications, psoriasis capacitance mapping (PCM) was introduced in order to assess both skin scaliness and water trapping inside the stratum corneum (inflammatory serum deposits) on lesional skin. PCM was used for assessing the therapeutic effects of ustekinumab on target lesions of 5 psoriatic patients. The reduction in the inflammatory dampness of the stratum corneum was conveniently seen after a 1-month ustekinumab treatment. The present pilot study suggests that PCM could be used as a fast and convenient method for assessing the anti-inflammatory efficacy of ustekinumab and other biotherapies.

Comparison between TEWL and laser scanning microscopy measurements for the in vivo characterization of the human epidermal barrier

The analysis of the skin barrier properties is important in various fields of medical treatment and cosmetology. The development and improvement of topically applied substances require an objective analysis of the skin barrier characteristics. Transepidermal water loss (TEWL) measurement is the standard method to characterize epidermal barrier function. The most important disadvantage of this method though, is that it can be affected by different exogenous and endogenous factors, e.g. water content of the applied formulation and room temperature. In the present study, TEWL measurements are compared to laser scanning microscopic (LSM) measurements, concerning the use of these two methods for the non-invasive in vivo characterization of the epidermal barrier function. The investigations were performed prior and subsequent to treatment of dry skin with a gel mixture, developed for skin treatment after radiotherapy for cancer. The present results indicate that in vivo laser scanning microscopy is an appropriate method for the characterization of the skin barrier structure without interference by external factors.

Biofunctional textiles prepared with liposomes: in vivo and in vitro assessment

A sun filter, ethyl hexyl methoxycinnamate (EHMC) used as a tracer, was vehiculized by liposomes made up of internal wool lipids (IWL) or phosphatidylcholine (PC) and applied onto cotton and polyamide fabrics by exhaustion treatments. After topical applications of textiles on human volunteers, skin properties were evaluated by non-invasive biophysical techniques. Two methodologies based on percutaneous absorption were used to determine the content of the active principle penetration into the skin. PC liposomes showed more affinity for the fabric than IWL liposomes. Moreover, polyamide fabrics absorbed a slightly higher percentage of liposomes than cotton fabrics. A significantly higher amount of EHMC skin penetration was found when the biofunctional textiles were topically applied than when formulations were applied onto the skin. Moreover, the polyamide was the fibre with the highest released properties in all cases.

Full-body skin mapping for six biophysical parameters: baseline values at 16 anatomical sites in 125 human subjects

BACKGROUND/AIM

The skin, as the outermost organ, protects against exogenous hazards (outside-in barrier) and prevents the loss of essential parts of the body (inside-out barrier). The epidermal barrier exerts several functions with specific morphological elements. Regional differences in skin functions are well known. The aim of the present study was to assess and compare skin physiological parameters in vivo at 16 anatomical sites: Barrier function in terms of transepidermal water loss (TEWL), stratum corneum (SC) hydration (assessed by capacitance), skin surface pH, skin surface temperature, erythema index and skin pigmentation were quantified at 16 anatomical sites under basal conditions. In addition, casual skin lipid level as a function of sebaceous lipids was measured on the forehead.

MATERIAL AND METHODS

The 6 functions at the 16 anatomical sites were assessed in a cohort of 125 volunteers working in the food processing industry. These functions were quantified with noninvasive instruments, namely a Tewameter (barrier function), a Corneometer (SC hydration), a pH-meter, a Mexameter (erythema index and pigmentation), a skin surface thermometer and a Sebumeter (casual sebum level).

RESULTS

We identified ranges for the 16 anatomical locations for each instrument and some parameters could be classified into distinctive groups. Furthermore, a left-right comparison was performed at 3 sites (dorsal hand, ventral hand and ventral forearm). Certain side differences could be shown for SC hydration, surface pH, erythema index, melanin index and skin surface temperature in the 3 assessed areas. A left-to-right, statistically nonsignificant difference was also established for TEWL.

CONCLUSION

The detected site-specific characteristics could be attributed to factors such as occlusion, different degrees of UV exposure, microcirculation and distribution of afferent and efferent nerve endings as well as fat distribution. External factors, such as life style, UV exposure and working conditions need to be taken into account. The present data are intended for an adequate selection of parameters and anatomical locations when assessing working conditions and designing clinical dermatological and pharmaceutical studies.

Quantitative analysis of dehydration in porcine skin for assessing mechanism of optical clearing

Dehydration induced by optical clearing agents (OCAs) can improve tissue optical transmittance; however, current studies merely gave some qualitative descriptions. We develop a model to quantitatively evaluate water content with partial least-squares method based on the measurements of near-infrared reflectance spectroscopy and weight of porcine skin. Furthermore, a commercial spectrometer with an integrating sphere is used to measure the transmittance and reflectance of skin after treatment with different OCAs, and then the water content and optical properties of sample are calculated, respectively. The results show that both the reduced scattering coefficient and dehydration of skin decrease with prolongation of action of OCAs, but the relative change in former is larger than that in latter after a 60-min treatment. The absorption coefficient at 1450 nm decreases completely coincident with dehydration of skin. Further analysis illustrates that the correlation coefficient between the relative changes in the reduced scattering coefficient and dehydration is ∼1 during the 60-min treatment of agents, but there is an extremely significant difference between the two parameters for some OCAs with more hydroxyl groups, especially, glycerol or D-sorbitol, which means that the dehydration is a main mechanism of skin optical clearing, but not the only mechanism.

Documentation of impaired epidermal barrier in mild and moderate diaper dermatitis in vivo using noninvasive methods

The presence of irritants from feces and urine with the concurrent mechanical friction and occlusion creates an environment in the diapered area that renders the skin prone to diaper dermatitis. Besides being a source of discomfort to the infant, these skin irritations pose a risk of secondary infections. In this study, we used noninvasive in vivo techniques to define measurable parameters that correlate with diaper dermatitis pathophysiology. In 35 infants (16 with mild or moderate and 19 without diaper dermatitis) we compared skin of diapered areas afflicted with diaper dermatitis to lesion-free diapered sites and to skin outside the diapered area (thigh). Our findings show significantly elevated cutaneous erythema, pH, and hydration, with significantly compromised water barrier function in involved areas compared to nonlesional sites both within and outside the diapered area. Furthermore, skin pH in nonlesional diapered skin for the diaper dermatitis cohort was significantly higher compared to the nondiapered sites. These observations are consistent with the current understanding of pathological skin changes in diaper dermatitis. In this study, we demonstrate that noninvasive methods can document relevant parameters to diaper dermatitis in vivo.

Silver-loaded seaweed-based cellulosic fiber improves epidermal skin physiology in atopic dermatitis: safety assessment, mode of action and controlled, randomized single-blinded exploratory in vivo study

BACKGROUND

The epidermal part of the skin is the major interface between the internal body and the external environment. The skin has a specific physiology and is to different degrees adapted for protection against multiple exogenous stress factors. Clothing is the material with the longest and most intensive contact to human skin. It plays a critical role especially in inflammatory dermatoses or skin conditions with an increased susceptibility of bacterial and fungal infections like atopic dermatitis. Previously, we have shown a dose-dependent antibacterial and antifungal activity of silver-loaded seaweed-based cellulosic fibres.

AIM OF THE STUDY

We studied the mode of action of silver-loaded seaweed-based cellulosic fiber and performed a broad safety assessment. The principal aim was to analyse the effects of wearing the textile on epidermal skin physiology in 37 patients with atopic dermatitis in a controlled, randomized single-blinded in vivo study. Furthermore, the sensitization potential was tested in a patch test in 111 panellists.

RESULTS

We could demonstrate in vitro a dose-dependent scavenging of induced reactive oxygen species by silver-loaded seaweed-based cellulosic fibers. Safety assessment of these fibres showed no detectable release of silver ions. Furthermore, ex vivo assessment after 24 h application both in healthy volunteers and patients with atopic dermatitis by sequential tape stripping and subsequently raster electron microscopy and energy dispersive microanalysis analysis revealed no detectable amounts of silver in any of stratum corneum layers. Serum analysis of silver showed no detectable levels. The in vivo patch testing of 111 volunteers revealed no sensitization against different SeaCell Active (SeaCell GmbH, Rudolstadt, Germany) containing fabrics. The in vivo study on 37 patients with known atopic dermatitis and mild-to-moderate eczema on their arms were randomly assigned to either silver-loaded seaweed fibre T-shirts or to cotton T-shirts for 8 weeks. A significant reduction in Staphylococcus aureus colonization was detectable for the silver T-shirts compared with cotton T-shirts without any changes in non-pathogenic surface bacteria colonization. Furthermore, a more pronounced improvement in barrier function (transepidermal water loss) was observed in mildly involved eczema areas during the first 4 weeks of the study. Stratum corneum hydration and surface pH improved in both treatment groups over time.

CONCLUSION

The tested silver-loaded seaweed fibre can be regarded as safe and seams to be suited for application in bio-active textiles in atopic dermatitis based on its positive in vivo activity.

Infant skin physiology and development during the first years of life: a review of recent findings based on in vivo studies

Infant skin is often presented as the cosmetic ideal for adults. However, compared to adult skin it seems to be more prone to develop certain pathological conditions, such as atopic dermatitis and irritant contact dermatitis. Therefore, understanding the physiology of healthy infant skin as a point of reference is of interest both from the cosmetic as well as from the clinical point of view. Clinical research on healthy infants is, however, limited because of ethical considerations of using invasive methods and therefore until recently data has been scarce. Technical innovations and the availability of non-invasive in vivo techniques, such as evaporimetry, electrical impedance measurement, in vivo video and confocal microscopy, and in vivo fibre-optic based spectroscopy, opened up the field of in vivo infant skin physiology research. Studies incorporating such methods have demonstrated that compared to adult, infant skin continues to develop during the first years of life. Specifically, infant skin appears to have thinner epidermis and stratum corneum (SC) as well as smaller corneocytes at least until the second year of life. The water-handling properties are not fully developed before the end of the first year and infant SC contains more water and less amounts of natural moisturizing factors. Such findings re-evaluate the old notions that skin is fully matured at birth. Armed with this knowledge, we are in a position not only to better understand infant dermatological conditions but also to design better skin care products respecting the distinct qualities of infant skin.

Nanosystems for skin hydration: a comparative study

The present investigation describes a comparative study for the design of innovative topical formulation for skin hydration. In particular, different colloidal forms based on lipidic components have been produced and characterized. Morphology and dimensional distribution have been investigated by means of electron microscopy and photon correlation spectroscopy. Nanoparticulate systems characterized by different morphology and dimensions depending on production procedures have been obtained, namely cubosomes, nanovesicles, solid lipid nanoparticles and liposomes. Hydration power has been studied by means of a corneometer, measuring the skin electrical capacitance before and after the application of opportunely viscosized nanoparticulate systems. It has been demonstrated that nanovesicle gel displayed a pronounced hydration power with respect to the other nanostructured forms, its hydration effect on skin was 3.5-fold higher, with respect to the untreated area, after 5 min from the application and 1.5-fold higher after 2 h.

Natural skin surface pH is on average below 5, which is beneficial for its resident flora

Variable skin pH values are being reported in literature, all in the acidic range but with a broad range from pH 4.0 to 7.0. In a multicentre study (N = 330), we have assessed the skin surface pH of the volar forearm before and after refraining from showering and cosmetic product application for 24 h. The average pH dropped from 5.12 +/- 0.56 to 4.93 +/- 0.45. On the basis of this pH drop, it is estimated that the 'natural' skin surface pH is on average 4.7, i.e. below 5. This is in line with existing literature, where a relatively large number of reports (c. 50%) actually describes pH values below 5.0; this is in contrast to the general assumption, that skin surface pH is on average between 5.0 and 6.0. Not only prior use of cosmetic products, especially soaps, have profound influence on skin surface pH, but the use of plain tap water, in Europe with a pH value generally around 8.0, will increase skin pH up to 6 h after application before returning to its 'natural' value of on average below 5.0. It is demonstrated that skin with pH values below 5.0 is in a better condition than skin with pH values above 5.0, as shown by measuring the biophysical parameters of barrier function, moisturization and scaling. The effect of pH on adhesion of resident skin microflora was also assessed; an acid skin pH (4-4.5) keeps the resident bacterial flora attached to the skin, whereas an alkaline pH (8-9) promotes the dispersal from the skin.

Equivalence of face and volar forearm for the testing of moisturizing and firming effect of cosmetics in hydration and biomechanical studies

The objective of the study was to compare measurements of skin hydration and of biomechanical properties performed on different zones of face and volar forearm. Two short-term (1 h) and two long-term (3 weeks) studies were conducted with a moisturizing and a firming product, respectively, on groups of female volunteers with dry skin. Measurements (Corneometer) and Dermal Torque Meter or DTM were performed on different zones of the face and of the volar forearm, 1 h after product application, and after 1, 2 and 3 weeks of repeated twice daily application. While the sebaceous-gland rich T-zone behaves differently, probably due to sebum/skin, sebum/product and/or sebum/measuring device interactions, there are no statistically significant differences between measurements made on temple, cheek, maxilla and volar forearm. The volar forearm is representative of the face for measuring skin hydration and biomechanical properties, and relevant for the assessment of the efficacy of cosmetic products destined for facial use.

Image analysis of skin scaling using D-Squame samplers: comparison with clinical scoring and use for assessing moisturizer efficacy

The severity of scaling disorders can be evaluated objectively using the D-Squame technique coupled with image analysis. The parameters of scaling derived using this approach need to be clinically relevant and should have greater discrimination than visual grading. Improvements to an existing method that fulfil these requirements are presented. Three scaling parameters were calculated using image analysis of digitized video-captured images of obliquely lit D-Squame samples. These parameters were compared to clinical scores of scaling made by five observers from photographs of the same areas sampled with D-Squame. In addition, two clinical studies were carried out to assess moisturizer effects on different degrees of xerosis, and to compare two different moisturizer preparations. The three scaling parameters gave correlation coefficients, r, between 0.6 and 0.75 when compared with global clinical scores of scaling. Significant reductions in all parameters were observed with 2 weeks of moisturizer use on lower leg skin with marked xerosis compared to an untreated control. The same moisturizer had a similar effect on milder xerosis of the forearm, and showed a greater decrease than a moisturizer with lower glycerol content. Increases in skin hydration, as measured with a corneometer, were also seen in both clinical studies, and corresponded well with D-Squame results. Differences in the degrees of scaling between these two anatomical sites were also detected with this technique. In a previous publication, the same technique was shown to be repeatable and reproducible; in the current article its correlation with clinical observations of scaling or flaking skin has been demonstrated.

Barreira cutânea na dermatite atópica

O estudo da barreira cutânea e de suas propriedades ganhou impulso a partir da década de 60, com estudos que apontaram sua resistência de forma isolada e suas propriedades com relação à permeação cutânea. Paralelamente, a descrição dos corpos de Odland auxiliou a compreensão da manutenção da estabilidade da camada córnea. O modelo brick & mortar, em que os corneócitos são os tijolos e o cimento são os lipídeos intercelulares, é o mais aceito, até o momento. Atualmente, há evidências consistentes de que o estrato córneo é uma estrutura metabolicamente ativa e exerce funções adaptativas. A barreira cutânea também tem um papel na resposta inflamatória, com ativação de melanócitos, angiogênese e fibroplasia, cuja intensidade depende, basicamente, da intensidade da agressão. As anormalidades da barreira cutânea da dermatite atópica são clinicamente observáveis pela presença de pele seca, achado muito frequente e significativo, que constitui parâmetro iagnóstico e de acompanhamento. O grau de hidratação da camada córnea, assim como a perda de água transepidérmica (transepidermal water loss - TEWL), estão relacionados com o grau de dano à barreira, constituindo parâmetros biofísicos que permitem acompanhar os pacientes de maneira não invasiva e com maior grau de sensibilidade.

The skin landscape following nonoptical capacitance imaging

Skin capacitance is an electrical property measurable at the level of the stratum corneum. Values are related to the moisture content of the tissue. Using the silicon image sensor technology, it has recently become possible to measure capacitance at 50 microm intervals on the skin surface. The resulting nonoptical picture corresponds to skin capacitance imaging. This novel tool for dermatologists highlights with precision the hollow skin surface patterns, including dermatoglyphics, the patterns of the shallow skin lines, and wrinkles. The topographic heterogeneity in skin surface hydration is made visible. In addition, the sweat gland and follicular openings are disclosed. Skin disorders induced by surfactants or presenting as hyperkeratotic areas, including some neoplasms, may show typical aspects. It is concluded that skin capacitance imaging brings added value to the clinical assessment performed by dermatologists.

Association of dietary fat, vegetables and antioxidant micronutrients with skin ageing in Japanese women

Daily diet may have implications for skin ageing. However, data on the relationship between diet and the parameters of skin conditions are scarce. The present study aimed to examine the associations of biophysical properties of the skin of women with intakes of fats and antioxidant micronutrients as well as food groups as sources of these nutrients. In a cross-sectional study, we measured the hydration, surface lipids and elasticity of the skin of 716 Japanese women using non-invasive techniques. The extent of facial wrinkles in the crow's-foot area was determined by observation using the Daniell scale. Each subject's usual diet was determined with the use of a validated FFQ. After controlling for covariates including age, smoking status, BMI and lifetime sun exposure, the results showed that higher intakes of total fat, saturated fat and monounsaturated fat were significantly associated with increased skin elasticity. A higher intake of green and yellow vegetables was significantly associated with a decreased Daniell wrinkling score. Intake of saturated fat was significantly inversely associated with the Daniell wrinkling score after additional adjustment for green and yellow vegetable intake. Further studies with more accurate measurement methods are needed to investigate the role of daily diet in skin ageing.